Commentary
Hepatic steatosis and gallstone disease are highly prevalent in the general population; the shared risk factors are age, ethnicity, obesity, insulin resistance, metabolic syndrome, atherosclerosis, risk of cardiovascular disease, and mortality. The presence of insulin resistance is the critical element in this association because it represents a crucial link between metabolic syndrome and NAFLD, as well as a higher susceptibility to gallstone formation. Clinical studies and systematic reviews suggest an association between gallstone disease, cholecystectomy, and hepatic steatosis.
As pointed out by I. Rodriguez-Antonio et al. (Translational Research Unit, Medica Sur Clinic & Foundation, Mexico), the bidirectional relationship between liver steatosis and gallstone disease and cholecystectomy is summarized in the role of insulin resistance, lipid metabolism, bile acids signalling pathways regulated by transcription factors expression, and to the gallbladder physiological role.
